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A road map for universal coverage: finding a pass through the financial mountains.

Samuel Y Sessions1, Philip R Lee

  • 1University of California, Los Angeles, CA, USA.

Journal of Health Politics, Policy and Law
|March 8, 2008
PubMed
Summary

Financing universal health insurance with taxes presents significant challenges, but a value-added tax (VAT) can fund a voucher system. This approach offers a politically realistic path to universal coverage.

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Area of Science:

  • Health Economics
  • Public Finance
  • Health Policy

Background:

  • Government finances over half of U.S. healthcare costs.
  • Universal health insurance proposals often involve government tax subsidies.
  • Taxation strategies for universal coverage are under-examined.

Purpose of the Study:

  • To examine specific taxes for financing universal health insurance.
  • To analyze challenges and solutions for tax-financed universal coverage.
  • To propose a politically realistic plan for universal coverage.

Main Methods:

  • Analysis of tax-financed universal health insurance models.
  • Examination of a value-added tax (VAT) funded voucher system.
  • Review of political and legislative strategies for health reform.

Main Results:

  • Taxation for universal coverage is more challenging than often perceived.
  • A VAT-funded voucher system illustrates key financing issues.
  • Significant problems exist but can be addressed with proposed solutions.

Conclusions:

  • Universal health insurance can be tax-financed through careful planning.
  • A bipartisan approach is feasible for enacting universal coverage.
  • Undisguised taxes offer a transparent funding mechanism for systemic health reform.